Man Collects Payments for Five Years
After Death of SSA Disability Beneficiary
The SSA OIG Fraud Hotline received an anonymous telephone call
on June 29, 2004, alleging that a Fort Lauderdale man was continuing
to receive his decased father's Social Security benefits. The
anonymous caller stated that the benefits were being directly
deposited into a joint account even though the man's father had
died almost 5 years earlier.
Our investigation revealed that the father had, in fact, died
in December 1999, and that the son had told others that he was
continuing to receive his father's benefits illegally, and that
he feared being caught. When the son became aware that he was
under investigation, he repaid $79,194 to SSA, which represented
the total amount of benefits paid since his father's death. However,
our investigation continued, and in December 2006, the son was
sentenced to 3 years' probation. At the sentencing, the judge
stated that he was imposing probation rather than imprisonment
only because the man had already made full restitution.
Father Conceals Child's Living Arrangements, Misuses $188,556
in Benefits
In June 2004, an SSA employee reported to OIG that a South Carolina
man was receiving child-in-care benefits on behalf of a disabled
adult child, and was also acting as the representative payee for
a child's own benefits. According to the SSA employee, the man
had not had the adult child in his care for more than a decade.
Our investigation confirmed that the child had not lived with
the man since 1991, during which time the man received more than
$109,000 in child-in-care benefits, and almost $108,000 as representative
payee. Although he was able to establish that some of these funds
were provided to the child's actual caretaker, a Federal Grand
Jury indicted the man on multiple charges. He entered a guilty
plea, and in November 2006, was sentenced to 1 year of incarceration
and 3 years' probation, and was ordered to pay restitution of
$188,556 to SSA.
Disability Beneficiary Claims Deceased Twin Sister Used Her
SSN to Work
Our Chicago Cooperative Disability Investigations (CDI) unit
received an allegation from the Hillside, Illinois SSA office
concerning alleged work activity by a Title II disability beneficiary.
Our investigation revealed that although the subject became disabled
in May 1997, wages were routinely posted to her SSA earnings record,
showing steady employment. When questioned, the subject informed
SSA that she was still disabled and unable to work. One of the
statements provided by the woman was an assertion that her twin
sister was using her Social Security number (SSN) to work.
CDI investigators found that the subject's twin sister died more
than 50 years ago. Further investigation revealed that the subject
had worked for a health care organization for the last 6 years.
She was confronted at her place of employment and admitted to
providing false information to SSA.
After pleading guilty to theft of Government funds, the beneficiary
was sentenced in February 2007 to 2 years' probation, 5 months'
home detention, and 200 hours of community service, and was ordered
to pay restitution of $89,314 to SSA.
Representative Payee Provides False Information on SSA Application
Our Norfolk, Virginia office investigated a representative payee
and her mother for concealment of information. The representative
payee was receiving Supplemental Security Income (SSI) disability
payments for her mother, brother, and daughter, but our investigation
revealed that she had lied about the family's living arrangements
on their SSI applications. In addition, the payee did not notify
SSA of her father's income or the fact that he was living in the
household.
After pleading guilty to obtaining SSI under false pretenses,
the woman was sentenced in January 2007 to 3 years' incarceration
(which was suspended), 10 years' supervised probation, and 200
hours of community service. She was also ordered (jointly and
severally with her mother) to pay restitution of $134,314 to SSA.
The woman's mother is awaiting sentencing.
Mother Fails to Notify SSA of Her Children's Living Arrangements
This case was based on a referral from the Rock Springs, Wyoming
SSA office to our Salt Lake City, Utah office. Our investigation
revealed that a mother receiving Title II survivors benefits for
her two children had failed to notify SSA that the children were
no longer in her care. One of the children left her care in December
2004 and the other in March 2005. The woman did not provide for
the children's needs; instead, she used the monies for her own
personal expenses.
In January 2007, after pleading guilty to misuse of Social Security
benefits and falsifying, concealing, or covering up a material
fact, she was sentenced to 6 months' imprisonment and 1 year of
probation, and was ordered to pay restitution of $10,863 to SSA.
OCCIG Activities
Woman
Agrees to $32,430 Civil Monetary Penalty (CMP) Settlement After
Full-Time Job Revealed
A 32-year-old woman began receiving Title II disability benefits
in 1997 due to depression, sleep apnea, and fibromyalgia. However,
in October 2003, she started working full-time as a tax preparer.
While still continuing to work, the woman reported on an SSA form
in October 2004 that she was not working at substantial levels.
The SSA field office was alerted to the woman's substantial earnings,
and SSA field office employees interviewed the woman. After the
woman confessed that she had been working as a tax preparer as
well as assisting with her husband's businesses, SSA referred
the case to OIG. After proposing a Civil Monetary Penalty, OCCIG
accepted an agreement whereby the woman agreed to pay SSA $32,430.
Woman Agrees to $53,120 CMP and Assessment After Concealing
Mother-in-Law's Death for 3 Years
A 55-year-old Texas woman who served as representative payee
for her mother-in-law continued to collect SSI for 3 years after
her mother-in-law's death. During this time, she made four misrepresentations
on Representative Payee Reports. The Chief Counsel to the Inspector
General proposed a Civil Monetary Penalty, and ultimately entered
into a Settlement Agreement with the woman under which she agreed
to pay a penalty and assessment totaling $53,120.
OA Activities
On April 7, 2006, the House of Representatives' Committee on
Ways and Means, Subcommittee on Social Security, requested information
from OIG regarding SSA's employer verification programs as well
as the accuracy of the SSA data used to verify employment eligibility.
We recently issued the following two reports related to these
requests.
Congressional Response Report: Employer Feedback on the Social
Security Administration's Verification Programs(View
Report A-03-06-26106)
The Subcommittee on Social Security asked us to provide information
on the experiences of employers who have used employee verification
programs administered by the Social Security Administration (SSA)
and the Department of Homeland Security (DHS). We looked at two
such programs, which use SSA data to allow employers to verify
the identity and/or employment eligibility of their employees.
These programs include 1) SSA's Social Security Number Verification
System (SSNVS), an on-line employee verification program; and
2) Basic Pilot, a Department of Homeland Security (DHS) program
in which SSA participates.
We found that many of the employers using SSNVS verified their
entire payroll, which SSA encourages to ensure accurate wage reporting.
However, of the employers using Basic Pilot, we found that about
42 percent were not using the program as intended.
We also found that most employers took appropriate actions when
they received unverified responses from SSNVS or nonconfirmation
responses from the Basic Pilot program. The employers notified
affected employees about the unverified results, and terminated
employees when they declined to contest the nonconfirmation responses.
While some employers reported problems in using each of the programs,
SSA and DHS were generally able to resolve these issues timely.
At least 98 percent of both programs' users indicated that they
were likely to continue using the programs.
Congressional Response Report: Accuracy of the Social Security
Administration's Numident File(View
Report A-08-06-26100)
SSA's Numident file contains relevant information about Social
Security numberholders, and is used in verification programs such
as the Basic Pilot. The Subcommittee on Social Security asked
us to assess the reliability of Numident data used in these programs.
In particular, the Chairman asked that we assess the accuracy
of SSA Numident fields that are relied on by the Basic Pilot,
for each of the following U.S. populations: (1) native-born citizens,
(2) foreign-born citizens, and (3) non-citizens.
We reviewed 810 randomly-selected Numident records in each of
the three populations for a total of 2,430 records. We reviewed
the records for accuracy, and to determine whether the records
that contained data discrepancies would result in inaccurate feedback
from the Basic Pilot program to the employer.
Given the scope of information held in SSA's Numident file, we
applaud the Agency on the accuracy of the data we tested. However,
we estimate that approximately 17.8 million (4.1%) Numident records
contain discrepancies that may result in incorrect Basic Pilot
feedback to employers. Because our sample included SSNs that were
assigned decades ago, we recognize that some records are too old
to be corrected. However, if even a portion of the estimated individuals
whose Numident records contained discrepancies were required to
visit an SSA office to correct their information, the Agency's
workload may significantly increase until such time as the affected
records were corrected.
We recently conducted an audit to determine the accuracy of payments
of Title II Disability Insurance (DI) claims with WC offsets.
Workers injured on the job may qualify for State and Federal workers'
compensation (WC) benefits in addition to SSA's Title II Disability
Insurance (DI) benefits. To prevent workers from earning more
in disability payments than their previous wages, Congress enacted
the WC offset provision, which requires SSA to reduce DI payments
by the amount of WC benefits.
We identified about 235,000 DI claims in which SSA records indicated
that a WC offset began between 1998 and 2004, and reviewed a random
sample of 250 claims. Of these 250 claims, 43 (17 percent) had
payment errors. Of these errors, 27 were directly related to the
WC offset calculation, and these errors totaled $158,590. Based
on our sample results, we estimated that approximately 25,377
DI claims totaling about $149.1 million had payment errors related
to the WC offset.
Though we found that most payment mistakes resulted from human
error, we were encouraged by a software enhancement which automated
some aspects of the process. However, accuracy still depends on
SSA staff decisions and the data they record when processing claims.
SSA agreed with all of our recommendations, including that SSA:
support legislation requiring States to make standardized WC information
available to SSA on a real-time basis; explore the feasibility
of electronic data exchanges with States; and increase management
oversight of the WC offset calculation.
Supplemental Security Income (SSI) Recipients Whose Medicare
Benefits Were Terminated Due to Death(View
Report A-01-06-26105)
We conducted this audit based on a suggestion from an SSA employee
who had identified several cases in which Supplemental Security
Income (SSI) payments continued even though the recipients' Medicare
benefits were terminated for death.
Using Medicare benefit information supplied by SSA, we identified
251 individuals whose SSI payments continued even though their
Medicare records indicated they were deceased. Of these, we found
that 86 (34 percent) were actually deceased and should no longer
be issued SSI payments. Although the Agency stopped payments timely
for 19 of these individuals, the remaining 67 individuals received
a total of $490,288 in incorrect payments. We estimated that SSA
could save $237,103 over the next 12 months by stopping payments
to the deceased recipients.
We also found that 165 of the 251 individuals in our audit were
alive and their Medicare benefits were incorrectly terminated.
Of these, SSA had terminated SSI payments to 85 individuals due
to death, despite the fact that they were alive. Because the Privacy
Act requires that SSA confirm information resulting from computer
matches before taking action to stop benefit payments, SSA policy
is to verify death reports received from third parties-including
CMS-before stopping SSI payments. However, we found that the SSI
payments to these 85 individuals were stopped without verification
because of limitations in SSA's computer systems.
SSA agreed to our recommendations, including that SSA review
the cases we identified in our audit and take appropriate action;
and that SSA confirm deaths reported from CMS before terminating
payments to SSI recipients.
Around OIG
Special Agent Jennifer Walker, National Coordinator for the Cooperative
Disability Investigations Program in the Office of Investigations,
was selected as a Gold/Silver Award Finalist for the Outstanding
Professional (Administrative, Management, and Specialist) Award
by the Federal Executive Board in Baltimore, Maryland. Congratulations
to Jennifer on this accomplishment.
Special Agent Gerald Maye received a Bronze Award Honorable Mention
in the Outstanding Supervisor category for his contribution to
the development of a robust electronic crimes program, and Jackie
White from the Office of Audit received a Bronze Award Honorable
Mention in the Outstanding Administrative Assistant/Management
Assistant category. Congratulations to both Gerald and Jackie.
Brian Karpe, an Audit Manager in the Office of Audit's Financial
Audit Division, recently began his detail in the Agency's Advanced
Leadership Program. The Advanced Leadership Program (ALP) is an
18-month program designed to provide high-potential employees
currently at the GS-13 and GS-14 levels with training and higher-level
developmental experiences to prepare them to become future Agency
leaders. Brian's first assignment is in the Office of Facilities
Management. Congratulations to Brian on his selection into the
program.
Deputy Assistant Inspector General for Resource Management Robert
Meekins was recently detailed to act as Director of the Allegation
Management Division, following the retirement of long-time Special
Agent-in-Charge Monica Machovec. Joscelyn Funnie of the Office
of Chief Counsel was selected to act as Deputy Assistant Inspector
General for Resource Management during this time. Congratulations
to both Robert and Joscelyn on their selection.
SSA
OIG Fraud Hotline Stats
From February 26-March 2, 2007, the SSA OIG Fraud Hotline received
973 allegations.
For the fiscal year, through March 2, 2007, the Hotline has received
a total of 18,662 allegations.
Our website provides guidelines for reporting fraud and a way
to submit an allegation to our Fraud Hotline. For more information,
visit www.socialsecurity.gov/oig.
Eye on OIG is published by the Office
of Communication,
Valerie Wood, Editor.
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Room.